Jan 11 IVF and Motherhood

On December 21, 2015, the Ontario government’s public funding of the first round of in vitro fertilization (IVF) treatment for infertile persons was enacted. Women will be able to receive the highly expensive procedure from 50 clinics across the province. Yet it is a well-known secret that the success rate of each individual IVF round is incredibly low: a 29.5% live-birth rate after one cycle, compared to 20.5% after the fourth cycle, 17.4% after the sixth, and 15.7% after the ninth cycle.[1] The study suggests that “persistence pays off” after the sixth attempt. For many, IVF is viewed as the only way to have a child. Whether the procedure is “worth it” is unquestionable compared to the longing for a baby of one’s own. Yet the accounts of women who undergo IVF are painful to read. Longing, worry, anxiety, depression, and pain are the dominant emotions in their stories. Even if they do end happily with a baby boy or girl, these women’s pregnancies and experiences as mothers are lived in the shadow of the pain of their former infertility. Beneath the procedure are the highly sensitive phenomena of infertility, motherhood, childbearing, parenting, longing, and love. Anne Taylor Fleming’s memoir,Motherhood Deferred: A Woman’s Journey (1994), offers a detailed look at her personal experiences with motherhood set to the backdrop of an exploration of her shifting cultural climate. Her experiences offer a glimpse into the relationship between being a woman and a mother, the longing for a child of one’s own, and how IVF deeply affects these realities.

Fleming grapples with the connection between being a woman and the desire for motherhood. What does it mean to be a mother? What is the desire for motherhood actually for? Fleming writes of the 60s and 70s that: “Abstaining from motherhood … was the boldest way to step out of the prescribed and proscribed sex role … [and] at that time had felt like the essence of being alive, the only chance of being fully alive, not being trapped.”[2] Motherhood was reconfigured as an option, but one that enslaved, rather than being the natural fulfillment of a woman’s inherent nature. From Fleming’s own descriptions, however, we hear evidence to the contrary—that motherhood is not an extrinsic choice, but an inherent longing: “[I am] a babyless baby boomer now completely consumed by the longing for a baby, a feeling akin to heartbreak when you can’t breathe but for the sensation of loss.”[3] In her late 30s and unable to conceive naturally, she is filled with a painful longing for the concrete flesh of a baby, despite her adamant rejection of maternity in her 20s. Fleming describes herself as being: “in thrall to a tactile hunger that makes my fingers tingle around babies, eager to stroke their soft flesh, my breasts yearning toward their newborn mouths, longing to give sustenance, hungry for their hunger.” She muses: “our yard looks green, fertile, fecund, and I, achy and hopeful, long to join the life-giving cycle, to be part of a birth, to give birth, to be green and lifeful.”[4] When she recalls the first prick of her desire for motherhood—in spite of her deep reluctance—she says:

It was not the first twinge of procreative longing so much as the first inkling of mortality. Did I really want to face the grave womb-tight and woebegone? … Did I not want to try something wholly new, court a different avenue of love—maternal love, now that this other kind, this man-woman kind had proved so thorny? Mine was not a full-hearted embrace of motherhood at this point, not at all, just … an awareness of the womb urge deep down inside like the first rumbles of hunger or the first flicker of thirst.[5]

Of her own accord, Fleming acknowledges that this longing was for both something more and also something coming from within, pointing to the presence of a desire that is at once ‘inside’ inside her and yet something that she cannot give to herself. The “womb urge deep down inside,” akin to hunger or thirst, is something she experiences as a natural inclination and not something that she chose at random. Motherhood is expressive of both a longing for and anopennessto something other than oneself. As Fleming notes, this human desire cannot be met solely on one’s own, and satisfaction is sought in companionship, often leading to marriage. A natural fruit of this longing and openness manifests itself in the new ‘other’ of the child.[6] Contrary to her initial ideas about womanhood and maternity, Fleming’s experiences in marriage pointed to a connection between the two that ran deeper than her ideas, choices, and circumstances.

Since the advent of the pill, Fleming is well aware that the “lovemaking urge” and the “babymaking urge” have been fundamentally wrenched apart. But her considerations point to a deeper consequence: the separation has also occurred in the psyche of women themselves: “sexual pleasure is now no longer an accidental byproduct of procreation, just as a baby is now no longer the byproduct of accidental afternoon lust. The very urges themselves … have become separated in women.”[7] In describing what sex was like between her and her husband after decades of contraception, Fleming writes: “I began to have an inkling of what birth control had wrought in my psyche, of how completely sex and procreation had become separated, of how indeed estranged I had become from my own body.”[8] But when their inability to conceive became apparent, “sex lost its life-making luster,” and she increasingly lost interest in it: “without the possibility of a baby, sex felt empty, laborious, clumsy.”[9] When her ambition finally aligned with wanting a baby she couldn’t have, it manifested as an all-consuming desire for a biological baby. With the unity of the procreative and nuptial act unraveled, the relationship between her and her husband also became fragmented. There was no longer “one body” between them, as he became a mere tool—the consenting sperm-provider—for her now solo-endeavor at becoming pregnant.

From her own experiences, Fleming is apt to describe how the despair of infertility combined with the promising lure of technology affects women who embark on assisted reproduction. “At age thirty-eight, I have entered the high-tech world of post-sexual procreation where things are done in dishes and through catheters, not in bed … I am about to have some kind of sexual encounter, but of this weird new kind: not with a person, but with a syringe of sperm.”[10]There are countless descriptions of the rounds of inseminations, hormone drugs and needles and failures that she undergoes, leaving her with a bruised and fragile body and heart/spirit. She explains how the drive to reproduce has “stunned” the infertile women “beyond the point of rationality,” and beyond the point of considering later repercussions, because of “the abject loneliness of non-[biological]motherhood.”[11]

Throughout her journey, she grapples with the moral questions about what she is doing as she confronts her realizations about the nature of the embryo and what it is to “make a baby.” The “teasing ability to make these embryos” is simultaneously “irresistible” and “heartbreaking,” because after being made they do not survive implantation, leading to disappointment. When she asks herself whether “life begins at conception,” she responds: “I must think no with part of my soul—else I could not do this; and yet I must think yes with another—else I could not do this—and there are many days I wish I had been born before any of this technology was available.”[12] This is revealing of the unprecedented moral quandaries that assisted reproduction puts men and women in: the decision over whether to use donor eggs, and deciding what to do with frozen embryos. For Fleming, using donor eggs would be “conceptual adultery,” and asks if “all this sharing of bodies and body parts … [is] a transgression of some basic order, of nature itself, and of the very notion of maternity,” and decides that she can’t succumb to buying another woman’s eggs. As for her frozen embryos, she does end up signing to have them donated for adoption, though she is “dazzled and bedeviled” by the thought that they can be “brought to life” by a stranger who will “suckle them, raise them, teach them to laugh and dance and look at the moon.”[13]

Fleming’s memoir felt like reading an autobiographical version of Margaret Atwood’s The Handmaid’s Tale. Both were difficult to digest because they present distortions of childbearing, male-female relationships, the body, and sex. The protagonist of Atwood’s account longs for ‘true things’—her own child, the touch of another human being, a relationship that is mutual and lasting. Her voice is eerily similar to that of Fleming, in her aching for things that are “natural”—to have a baby in their womb that is the fruit of affection and love. From her lived experience, Fleming acutely reveals the element of unity that exists between one’s body (including the sexual act) and one’s identity. She writes:

You couldn’t just run up and down that freeway with a jar of sperm in your purse or lie in those stirrups day after day and not sort through memories. They came together, a compound package: baby making and soul-searching … [they put] you up against everything you had been before and who you would be after.[14]

She cannot enter this “post-sexual world” of “high-tech baby making” without considering who she is—her identity as it was past, present, and future. Procreation profoundly affects the way you conceive who you are and your relationship to others. Childbearing is thus not isolated from profound questions of being: what does it mean to give life? What does it mean to have a child?

Even within a dystopia, human longing remains. It is a longing for the truth of one’s being. For Fleming, it was only through her struggle that she began to recognize the mystery and miracle of birth, and the extreme inadequacy of IVF: “I am just beginning to learn, to be humbled, to wonder how in the world anyone so easily gets pregnant and how inept we are at trying to duplicate the elegant choreography of nature.”[15] Her account speaks of all that is amiss in the world of post-sexual reproduction, and the hurt done to the women who seek redemption from their infertility in technology. The number of surgeries that women undergo and the physical and emotional tolls that the procedures take on their bodies is shocking and saddening to read—not to mention the way in which infertility doctors are often falsely ‘optimistic,’ dangling “dazzling new techniques” that hold promise to women. Fleming describes how “the infertility business had a maddening momentum” despite its constant failure, and that “when you were in it, riding back and forth to the clinic, toting around needles and drugs like a junkie, having your ovaries prodded and peered at on the sonogram screen, day after day, you felt perversely alive, part of the baby-conjuring process.” However, as she “disappeared further and further into infertility, it started feeling less like a life-affirming process and more like an obsessional search for that embryo, that baby, that thing.”[16] As a solution to infertility, Fleming’s voice helps us see that IVF is not only profoundly inadequate, but also harmful to the women and families involved.

[6] What needs to be explored here is the philosophy of womanhood, which John Paul II takes up in his apostolic letter, “On the Dignity and Vocation of Women.” See also Colleen Carrol Campbell’s memoir, My Sisters the Saints,which is also about her struggle with infertility, but her exploration of the nature of womanhood and motherhood runs philosophically and anthropologically deeper.